After Louisville's third straight loss, coach Rick Pitino is declaring the next one a "must game."

He has a lot to work on before then.

Peyton Siva got into foul trouble and was held scoreless for the first time since he was a freshman, Russ Smith didn't look comfortable in a new role off the bench, and late-game free throw shooting was lacking again Saturday as the fifth-ranked Cardinals were upset 53-51 by Georgetown.

Louisville (16-4, 4-3 Big East) has its longest losing streak since January 2010. No. 1 in the country a week ago, the Cardinals have fallen to Syracuse, Villanova and Georgetown and have Pittsburgh at home on Monday.

"We have to get this win. It's a must game for us," Pitino said. "Because four (in a row), now you're on the verge of getting a sub-.500 record in the league, and you don't want to mess with that."

Pitino shook up the lineup by going with Luke Hancock over Smith, who is being asked to distribute more and score less after three poor shooting games this month. Smith entered the game averaging 18.7 points but recently had performances of 2 for 11, 2 for 13 and 2 for 13 from the field.

Smith still got his time on the court — he scored 12 points on 4-for-9 shooting in 29 minutes — but he had only two assists.

"I'm just trying to stay positive about the whole situation and look for my guys," he said. "I didn't get a chance to create my own shot because there are going to be some bad shots, and Coach doesn't want that, so I've just got to get the offensive moving a bit.

"At the end of the day I'm know I'm going to play. And I know how good I am. I've proven myself already. I don't have to go out there and just try and murder the other team or just try and throw up points. I go out there now to just do what Coach asks me to do. He wants to do things a little bit differently now."

Pitino said he will stay with the change for now. The coach also explained why he was fine with Siva taking the potential game-winning jumper with 1.4 seconds to play, even though the senior had taken only one other shot in the game.

"We got a decent shot," Pitino said. "Wasn't a great shot, it was a decent shot, and I want him to get his confidence going a little bit as well."

The Cardinals went 12 for 12 from the free throw line in the first half but just 4 for 10 in the second, echoing a problem from recent games. Pitino said it was a concern, but he was more bothered that his team was outrebounded 34-29.

"It was the backboard that cost us the game, not the free throw line," he said. "If we block out, we're in control of our destiny."

Aaron Bowen's acrobatic tip-in — his only points of the game — gave Georgetown a 52-50 lead with 3½ minutes remaining. Louisville's Chane Behanan made 1 of 2 free throws to cut the lead to one with 2:22 to play. The Cardinals had several chances to take the lead after that, including after they regained possession on a disputed held ball with 30 seconds to play.

Louisville dribbled down the clock, but Siva's jumper was off target. Georgetown's Otto Porter grabbed the rebound — his 12th of the game — and was fouled. He then made 1 of 2 free throws to finish with 17 points for the Hoyas (14-4, 4-3 Big East).

Smith, Hancock and Gorgui Dieng all scored 12 points to lead the Cardinals.

Georgetown is 4-1 since Greg Whittington, the school's second-leading scorer on the season, was sidelined indefinitely due to academic reasons.